摘要
目的研究头颈部肿瘤患者放疗期间医院感染影响因素及中性粒细胞比值(NEUT)、可溶性肿瘤坏死因子受体-I(sTNF-RI)表达变化。方法选取2019年1月-2020年1月九江市第一人民医院收治的头颈部肿瘤患者600例作为研究对象,另选取同期于医院行健康体检的健康志愿者100名作为健康对照组。分析患者放疗期间医院感染病原菌分布及影响因素,检测入组研究对象NEUT、sTNF-RI水平差异。结果600例头颈部肿瘤患者放疗期间120例患者发生医院感染,感染率为20.00%(120/600),其中以口腔部位感染发生率最高为48.33%(58/120);头颈部肿瘤患者放疗期间医院感染与年龄、合并基础疾病、住院时间、侵袭性操作、抗生素使用种类相关(P<0.05);120例头颈部肿瘤患者放疗期间感染患者共检出68株病原菌,其中革兰阴性菌32株,占比47.06%(32/68),真菌23株,占比33.82%(23/68),革兰阳性菌13株,占比19.12%(13/68);与健康对照组相比,未感染组、感染组NEUT、sTNF-RI水平均升高(P<0.05);与未感染组相比,感染组NEUT、sTNF-RI水平更高(P<0.05)。结论头颈部肿瘤患者放疗期间感染与多种因素相关,其病原菌以革兰阴性菌最为常见,且NEUT、sTNF-RI异常升高,临床可根据其变化预测头颈部肿瘤患者放疗期间医院感染的发生。
OBJECTIVE To explore the influencing factors for nosocomial infection in the patients with head and neck tumors and observe the changes of neutrophil ratio(neutrophil ratio,NEUT)and soluble tumor necrosis factor receptor-I(sTNF-R I)during radiotherapy.METHODS Totally 600 patients with head and neck tumors who were treated in the Jiujiang First People′s Hospital from Jan 2019 to Jan 2020 were recruited as the study subjects,meanwhile,100 healthy people who received physical examination were set as the control group.The distribution of pathogens and influencing factors for nosocomial infection during the radiotherapy were observed,and the levels of NEUT and sTNF-RI were detected.RESULTS Of the 600 patients with head and neck tumors,120 had nosocomial infection during the radiotherapy,with the infection rate 20.00%(120/600).The incidence rate of oral infection was the highest 48.33%(58/120).The nosocomial infection in the patients with head and neck tumors during the radiotherapy was associated with age,complication with underlying diseases,length of hospital stay and types of antibiotics(P<0.05).A total of 68 strains of pathogens were isolated from the 120 patients with head and neck tumors during chemoradiotherapy,32(47.06%,32/68)of which were gram-negative bacteria,23(33.82%,23/68)were fungi,and 13(19.12%,13/68)were gram-positive bacteria.The levels of NEUT and sTNF-RI of the non-infection group and the infection group were significantly higher than those of the control group(P<0.05);the levels of NEUT and sTNF-RI of the infection group were significantly higher than those of the non-infection group(P<0.05).CONCLUSION There are a variety of factors that are associated with the infection in the patients with head and neck tumors during the chemotherapy,the gram-negative bacteria are the most common pathogens,the levels of NEUT and sTNF-RI are abnormally elevated,and it is necessary for the hospital to predict the incidence of nosocomial infection based on the changes of the indexes during the chemoradiotherapy.
作者
叶威
左宏波
崔文婷
彭金娣
陈雪礼
王璐
YE Wei;ZUO Hong-bo;CUI Wen-ting;PENG Jin-di;CHEN Xue-li;WANG Lu(Jiujiang First People's Hospital,Jiujiang,Jiangxi 332000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第24期3750-3753,共4页
Chinese Journal of Nosocomiology
基金
江西省卫生计生委科技计划基金资助项目(20167089)。
